Skin treatments containing retinoic acid could help prevent skin ulcers in people with diabetes, research shows.

Ulcers are far more than a cosmetic problem. They signal diabetes-related problems with wound healing.

Complications from diabetes, like nerve and blood vessel damage, increase the risk of ulcers. And if the nerves that signal pain have been damaged, the patient may not know he or she has an ulcer.

That can turn minor wounds into big problems. “Diabetic ulcers of the lower limbs and feet, in particular, are associated with high morbidity and often lead to amputation,” says a new study from the University of Michigan.

Retinoic acid might help avoid the problem, say the researchers.

In lab tests, retinoic acid helped the skin wounds of diabetic rats heal faster. That could cut down on chronic ulcers, say James Varani, PhD, and colleagues.

Retinoic Acid’s Reputation

Retinoic acid is no stranger to skin lotions. Made from vitamin A, it’s the active ingredient in prescription treatments Retin A, and Renova.

Retinoic acid and other derivatives of vitamin A have also been used for skin problems including acne and signs of sun damage (wrinkles, brown spots, and rough skin).

However, the potions are powerful. They can irritate the skin, causing redness, dryness, and flakiness. These medications should not be used if you are pregnant or if you plan to become pregnant.

Faster Wound Healing

In the latest study, a retinoic-acid-containing lotion was applied to diabetic and nondiabetic rats every other day for eight weeks. Other rats got the same lotion but without the retinoic acid.

After eight weeks, the treatments ended and the rats got minor skin wounds.

As expected, the wounds healed faster in the nondiabetic rats.

Among the diabetic rats, wounds healed faster in the retinoic acid group. Within six days, 85 percent of their wound had healed, compared with 41% for the diabetic rats that didn’t get retinoic acid.

The healing wounds also looked a bit different in the diabetic rats that had gotten retinoic acid. Their scabs had fewer abnormalities, says the study.

Since faster-healing wounds are less likely to form chronic ulcers, retinoic acid might curb the risk of diabetic skin ulcers, the researchers conclude.

What About Aging?

Just like everyone else, people with diabetes are vulnerable to sun damage.

“It should be kept in mind that diabetes is a progressive disease, and its consequences are often seen after years or decades,” says the study.

“Thus, the effects of diabetes on the skin may be superimposed on the negative changes that occur as a result of the aging process itself. “In this regard, the effects of diabetes on the skin may be analogous to what is seen in [sun] damage.”

It should be possible to find a way to get the skin benefits of retinoids without the irritation, the researchers add.

The study, which doesn’t make recommendations for diabetes patients, appears in the March issue of Diabetes.

By Miranda Hitti, reviewed by Brunilda Nazario, MD

SOURCES: Lateef, H. Diabetes, March 2005; vol 54: pp 855-861. WebMD Feature: “Nourishing Your Skin.” WebMD Medical Reference from “Nutrition & Pregnancy: A Guide from Preconception to Postdelivery”: “Becoming Nutritionally Prepared For The First Two Months Of Pregnancy.”